| NPI | 1922219211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: IL 036-128987) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: OH 35088749) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2021-07-01 |